不同导航方法下全膝关节置换术的临床对线差异
Clinical alignment variations in total knee arthroplasty with different navigation methods.
作者信息
Stephens Byron F, Hakki Sam, Saleh Khaled J, Mihalko William M
机构信息
University of Tennessee - Campbell Clinic Department of Orthopaedics & Biomedical Engineering, 1211 Union Ave, Suite 510, Memphis, TN 38104, USA.
Department of Orthopaedic Surgery, Bay Pines Veterans Administration Health Care System, 10000 Bay Pines Boulevard North, Bay Pines, FL 33744, USA.
出版信息
Knee. 2014 Oct;21(5):971-4. doi: 10.1016/j.knee.2014.03.001. Epub 2014 Mar 12.
BACKGROUND
We compared the resulting alignment in 90° of flexion and in full extension after total knee arthroplasty (TKA) with two navigation systems using different techniques: a measured resection (MR) system and a gap - balancing (GB) system.
METHODS
Varus and valgus alignment in extension and flexion was compared in 100 consecutive patients who had TKA with an MR distal-femoral-cut-first technique at one institution and 100 consecutive patients in whom a GB tibial-cut-first technique was used at another institution. Alignment deviation of three degrees or more from neutral was considered an outlier.
RESULTS
No significant difference between the groups in coronal alignment in extension or flexion was found, but there were three times the number of outliers for clinical alignment in flexion for the MR group compared to the GB group.
CONCLUSIONS
The use of the GB tibial-cut-first computer-assisted TKA navigation may provide a more consistent clinical alignment in flexion than systems using an MR technique.
LEVEL OF EVIDENCE
Therapeutic study. Level 2.
背景
我们使用两种不同技术的导航系统，比较了全膝关节置换术（TKA）后90°屈曲位和完全伸直位时的对线结果：测量截骨（MR）系统和间隙平衡（GB）系统。
方法
在一家机构对100例采用MR股骨远端先截骨技术进行TKA的连续患者，以及在另一家机构对100例采用GB胫骨先截骨技术的连续患者，比较其伸直位和屈曲位的内翻和外翻对线情况。与中立位相差3度或更多的对线偏差被视为异常值。
结果
两组在伸直位或屈曲位的冠状面线方面未发现显著差异，但与GB组相比，MR组屈曲位临床对线的异常值数量是GB组的三倍。
结论
与使用MR技术的系统相比，采用GB胫骨先截骨的计算机辅助TKA导航可能在屈曲位提供更一致的临床对线。
证据水平
治疗性研究。2级。
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